Nitazene analogs, a novel class of synthetic opioids more potent than fentanyl, detected in Philadelphia

 

• Nitazene analogs are synthetic opioids that are up to 40 times more potent than fentanyl 

• First identified in the United States in 2019 

• First identified in Philadelphia as early as October 2022 

• Individuals who experience an opioid overdose after using nitazene analogs will respond to naloxone (e.g., Narcan®). 

What are nitazene analogs? Nitazene analogs are a novel class of synthetic opioids that can be up to 40 times more potent than fentanyl and up to 500 times more potent than morphine. Nitazene analogs vary in potency and include isotonitazene, metonitazene, and N-pyrrolidino etonitazene. The Drug Enforcement Administration has classified ten nitazene analogs as Schedule I drugs since there is no approved medical use for nitazene analogs in the United States, and initial pharmacologic evaluations do not support any medical or veterinary use.i,ii,iii However, novel nitazene analogs that are not explicitly scheduled in the United States, such as N-desethyl isotonitazene, continue to be discovered through drug checking programs.   In December 2022, N-desethyl isotonitazene was the first nitazene analog to be detected in the Philadelphia drug supply among four unique samples suspected to be “dope” with the following stamps: “hearse”, “atco”, and “show and tell”. There are indications, however, that nitazene analogs were present in the drug supply as early as October 2022. 

https://hip.phila.gov/document/3203/PDPH-HAN_Alert_2_NitazeneAnalogs_12.21.2022.pdf/